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CARISSA CANNON
NPI 1609509454
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since July 07, 2022
11601 S WESTERN AVE, LOS ANGELES, CA 90047(323) 242-5000 Get Directions Write a Review

NPPES record last updated: October 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Carissa Cannon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARISSA CANNON (NPI 1609509454) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1609509454
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameCARISSA CANNON
Location Address11601 S WESTERN AVELos Angeles, CA 90047-5006
Mailing Address11601 S Western AveLos Angeles, CA 90047-5006 · (323) 242-5000
Phone(323) 242-5000
Sole ProprietorNo
Enumeration DateJuly 7, 2022
Last NPPES UpdateOctober 16, 2025
NPPES CertifiedOctober 16, 2025
✔ NPI 1609509454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
11601 S WESTERN AVE, Los Angeles, CA 90047
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARMEN BRAMASCO
Student in an Organized Health Care Education/Training Program
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 242-5000
MARGARET JOHNSON BROWN
Rehabilitation Practitioner
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 242-5000
MANDEE ASHLEIGH DURAN MA
Marriage & Family Therapist
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 240-5000
EDITH CAMPOS
Counselor (Mental Health)
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 242-5000
DOMINIQUE LANISE DORSEY
Social Worker (Clinical)
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 242-5000
IDELLE CARMONA
Day Training/Habilitation Specialist
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 242-5000
JASON SODENKAMP
Counselor (Addiction (Substance Use Disorder))
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 242-5000
MICHAEL WAYNE BRAY
Student in an Organized Health Care Education/Training Program
11601 S WESTERN AVE
LOS ANGELES, CA 90047
Los Angeles County (323) 242-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carissa Cannon's NPI number?

The NPI number for Carissa Cannon is 1609509454. It was assigned to this individual provider in the NPPES registry on July 7, 2022.

Where is Carissa Cannon located?

Carissa Cannon practices at 11601 S Western Ave, Los Angeles, CA 90047. The listed phone number is (323) 242-5000.

What is Carissa Cannon's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Carissa Cannon was last updated on October 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.